Insurance Claim Review

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  Subject Areas on Research

  • "Compensation for Birth-Related Injury: No-Fault Programs Compared With Tort System" 
  • A Positive Association Between Hospice Profit Margin And The Rate At Which Patients Are Discharged Before Death. 
  • A Primer for Managed Care Residents: How to Conduct Research Using Live Medical and Pharmacy Claims Data. 
  • Administrative claims data to support pragmatic clinical trial outcome ascertainment on cardiovascular health. 
  • Admission, discharge, or change in B-type natriuretic peptide and long-term outcomes: data from Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF) linked to Medicare claims. 
  • Adverse Events and Bundled Costs after Cranial Neurosurgical Procedures: Validation of the LACE Index Across 40,431 Admissions and Development of the LACE-Cranial Index. 
  • An examination of Alzheimer's disease case definitions using Medicare claims and survey data. 
  • Analysis of Time Trends in Alzheimer's Disease and Related Dementias Using Partitioning Approach. 
  • Are Trends in Hospitalization Prior to Hospice Use Associated With Hospice Episode Characteristics? 
  • Assessing outcomes for consumers in New York's assisted outpatient treatment program. 
  • Association Between Switching to a High-Deductible Health Plan and Major Cardiovascular Outcomes. 
  • Association of Vision Loss With Hospital Use and Costs Among Older Adults. 
  • Beyond volume: does hospital complexity matter?: an analysis of inpatient surgical mortality in the United States. 
  • Centers for medicare and medicaid services medicare data and stroke research: goldmine or landmine? 
  • Certificate of Need (CON) for cardiac care: controversy over the contributions of CON. 
  • Challenges in merging Medicaid and Medicare databases to obtain healthcare costs for dual-eligible beneficiaries: using diabetes as an example. 
  • Changes in guideline-recommended medication possession after implementing Kendra's law in New York. 
  • Changes in incidence of diabetes mellitus-related eye disease among US elderly persons, 1994-2005. 
  • Claims-based cardiovascular outcome identification for clinical research: Results from 7 large randomized cardiovascular clinical trials. 
  • Colorectal Cancer Screening in a Nationwide High-deductible Health Plan Before and After the Affordable Care Act. 
  • Comparative Effectiveness of Vertical Sleeve Gastrectomy Versus Roux-en-Y Gastric Bypass for Diabetes Treatment: A Claims-based Cohort Study. 
  • Comparison of 30-day mortality models for profiling hospital performance in acute ischemic stroke with vs without adjustment for stroke severity. 
  • Comparison of Neoadjuvant and Adjuvant Chemotherapy in Muscle-invasive Bladder Cancer. 
  • Competition in Outpatient Procedure Markets. 
  • Comprehensive support of family caregivers: Are there health system cost offsets? 
  • Consultation at twilight. 
  • Continuing medication and hospitalization outcomes after assisted outpatient treatment in New York. 
  • Cost analysis of myasthenia gravis from a large U.S. insurance database. 
  • Cost efficiency of anticoagulation with warfarin to prevent stroke in medicare beneficiaries with nonvalvular atrial fibrillation. 
  • Cost of care for common back pain conditions initiated with chiropractic doctor vs medical doctor/doctor of osteopathy as first physician: experience of one Tennessee-based general health insurer. 
  • Criterion validity of Medicare chemotherapy claims in Cancer and Leukemia Group B breast and lung cancer trial participants. 
  • Defining care provided for breast cancer based on medical record review or Medicare claims: information from the Centers for Disease Control and Prevention Patterns of Care Study. 
  • Dementia and Medicare at life's end. 
  • Despite 'welcome to Medicare' benefit, one in eight enrollees delay first use of part B services for at least two years. 
  • Differences in Hospital Readmission Risk across All Payer Groups in South Carolina. 
  • Disappearing and reappearing differences in drug-eluting stent use by race. 
  • Does health plan generosity enhance hospital market power? 
  • Economic outcomes with prasugrel versus clopidogrel in acute coronary syndrome patients: observations from prasugrel users and matched clopidogrel users. 
  • Effect of switching to a high-deductible health plan on use of chronic medications. 
  • Effects of diagnosed dementia on Medicare and Medicaid program costs. 
  • Estimated cost of treating myasthenia gravis in an insured U.S. population. 
  • Factors influencing the health care expenditures of patients with laryngeal disorders. 
  • Follow-up visits by provider specialty for patients with major depressive disorder initiating antidepressant treatment. 
  • Four States With Robust Prescription Drug Monitoring Programs Reduced Opioid Dosages. 
  • Glaucoma, Alzheimer disease and other dementia: a longitudinal analysis. 
  • HSR Commentary: Linking VA and Non-VA Data to Address Important US Veteran Health Services Research Issues. 
  • Health Care Resource Utilization and Costs Among Medicare Beneficiaries Newly Diagnosed With Peripheral T-cell Lymphoma: A Retrospective Claims Analysis. 
  • Health Care Resource Utilization and Management of Chronic, Refractory Low Back Pain in the United States. 
  • Health Care Utilization and Comorbidity History of North Carolina Medicaid Beneficiaries in a Controlled Substance "Lock-in" Program. 
  • Health Level Seven. '96 Health Insurance Portability and Accountability Act. 
  • High-deductible health plans and costs and utilization of maternity care. 
  • High-deductible health plans and low-value imaging in the emergency department. 
  • Hospital-Based Palliative Care with Medicare Claims: Evidence From Colorado. 
  • Identification of dementia: agreement among national survey data, medicare claims, and death certificates. 
  • Identification of patients with diabetic macular edema from claims data: a validation study. 
  • Impact of co-pay assistance on patient, clinical, and economic outcomes. 
  • Improving the prediction of medication compliance: the example of bisphosphonates for osteoporosis. 
  • Incident Substance Use Disorder Following Anxiety Disorder in Privately Insured Youth. 
  • Is there empirical evidence for "Defensive Medicine"? A reassessment. 
  • Is withholding osteoporosis medication after fracture sometimes rational? A comparison of the risk for second fracture versus death. 
  • Linking the National Cardiovascular Data Registry CathPCI Registry with Medicare claims data: validation of a longitudinal cohort of elderly patients undergoing cardiac catheterization. 
  • Longer term effects of total knee arthroplasty from a national longitudinal study. 
  • Measuring clinically significant chemotherapy-related toxicities using Medicare claims from Cancer and Leukemia Group B (CALGB) trial participants. 
  • Measuring the burden of multimorbidity among Medicare beneficiaries via condition counts and cumulative duration. 
  • Medical Marijuana Laws Reduce Prescription Medication Use In Medicare Part D. 
  • Medical care surrounding work-related back injury claims among Washington State Union Carpenters, 1989-2003. 
  • Medicare managed care enrollment by disability-eligible and age-eligible veterans. 
  • Methodological considerations in using claims databases to evaluate persistence with bisphosphonates for osteoporosis. 
  • Nonadherence to Guideline Recommendations for Tympanostomy Tube Insertion in Children Based on Mega-database Claims Analysis. 
  • Novel application of approaches to predicting medication adherence using medical claims data. 
  • Occupational impairment and disability among applicants for Social Security disability benefits in Pennsylvania. 
  • Over- and under-treatment of TB patients in Eastern China: an analysis based on health insurance claims data. 
  • Payer database and geospatial analysis to evaluate practice patterns in treating allergy in North Carolina. 
  • Performance-based outcomes of inpatient rehabilitation facilities treating hip fracture patients in the United States. 
  • Permanent pacemaker use among patients with heart failure and preserved ejection fraction: Findings from the Acute Decompensated Heart Failure National Registry (ADHERE) National Registry. 
  • Postoperative Opioid Prescribing and the Pain Scores on Hospital Consumer Assessment of Healthcare Providers and Systems Survey. 
  • Prescription patterns for children with juvenile idiopathic arthritis in Michigan Medicaid: a comparison by prescriber type. 
  • Prevalence and causes of dysphonia in a large treatment-seeking population. 
  • Private insurers' payments for routine physician office visits vary substantially across the United States. 
  • Process of care performance measures and long-term outcomes in patients hospitalized with heart failure. 
  • Quality of Care and Ischemic Stroke Risk After Hospitalization for Transient Ischemic Attack: Findings From Get With The Guidelines-Stroke. 
  • Rates and costs of respiratory illness in coal mining: a cross-industry comparative analysis. 
  • Rates of and circumstances surrounding work-related falls from height among union drywall carpenters in Washington State, 1989-2008. 
  • Rates of glaucoma medication utilization among persons with primary open-angle glaucoma, 1992 to 2002. 
  • Rates, amounts, and determinants of ambulatory blood pressure monitoring claim reimbursements among Medicare beneficiaries. 
  • Relationship between Hospital 30-Day Mortality Rates for Heart Failure and Patterns of Early Inpatient Comfort Care. 
  • Resource use and costs associated with diabetic macular edema in elderly persons. 
  • Return on investment for bariatric surgery. 
  • Review of Neurosurgery Medical Professional Liability Claims in the United States. 
  • Review of Ophthalmology Medical Professional Liability Claims in the United States from 2006 through 2015. 
  • Risk adjustment for Medicare beneficiaries with Alzheimer's disease and related dementias. 
  • Robbing Peter to pay Paul: did New York State's outpatient commitment program crowd out voluntary service recipients? 
  • Role of health plan administrative claims data in participant recruitment for pragmatic clinical trials: An Aspirin Dosing: A Patient-centric Trial Assessing Benefits and Long-term Effectiveness (ADAPTABLE) example. 
  • Rural-urban differences in preventable hospitalizations among community-dwelling veterans with dementia. 
  • Sensitivity of International Classification of Diseases codes for hyponatremia among commercially insured outpatients in the United States. 
  • Service utilization comparison of South Carolina Medicaid fee-for-service (FFS), Physician Enhanced Plan (PEP) and Health Maintenance Organization (HMO) models. 
  • Study of Cardiovascular Health Outcomes in the Era of Claims Data: The Cardiovascular Health Study. 
  • Successful Community Discharge Following Postacute Rehabilitation for Medicare Beneficiaries: Analysis of a Patient-Centered Quality Measure. 
  • The Association between High-Deductible Health Plan Transition and Contraception and Birth Rates. 
  • The Effect of Obstructive Sleep Apnea on Absolute Risk of Central Serous Chorioretinopathy. 
  • The association between the supply of select nonpharmacologic providers for pain and use of nonpharmacologic pain management services and initial opioid prescribing patterns for Medicare beneficiaries with persistent musculoskeletal pain. 
  • The economic burden of anemia in cancer patients receiving chemotherapy. 
  • Treating age-related macular degeneration: comparing the use of two drugs among medicare and veterans affairs populations. 
  • Treatment patterns for prostate cancer: comparison of Medicare claims data to medical record review. 
  • Use of health care claims data to study patients with ophthalmologic conditions. 
  • Use of the ICD-10 vision codes to study ocular conditions in Medicare beneficiaries with stroke. 
  • Using "big data" to capture overall health status: properties and predictive value of a claims-based health risk score. 
  • Using physician claims to identify postoperative complications of carotid endarterectomy. 
  • Variation in Postpartum Glycemic Screening in Women With a History of Gestational Diabetes Mellitus. 
  • Venous thromboembolism risk in patients with cancer receiving chemotherapy: a real-world analysis. 
  • What Contributes Most to High Health Care Costs? Health Care Spending in High Resource Patients. 
  • What is the marginal benefit of payment-induced family care? Impact on Medicaid spending and health of care recipients. 
  • Women and outpatient mental health services: use by black, Hispanic, and white women in a national insured population. 
  • Work-related illness and injury claims among nationally certified athletic trainers reported to Washington and California from 2001 to 2011. 
  • Worksite medical home: health services use and claim costs. 
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  Keywords of People

  • Curtis, Lesley H., Professor in Population Health Sciences, Medicine, General Internal Medicine
  • Mruthyunjaya, Prithvi, Adjunct Associate Professor in the Department of Ophthalmology, Ophthalmology, Vitreoretinal Diseases & Surgery
  • O'Connor, Christopher Michael, Adjunct Professor in the Department of Medicine, Medicine, Clinical Pharmacology